Treating Stings and Burns at the Beach

Brobson Lutz M.D.

“One morning in Panama City I was riding a bicycle on hard sand, hit a rut and scraped my leg,” says Johnny Wayne Walker, superintendent for an oil rig near Lafitte, La. “Later that afternoon I was in the surf. All of a sudden my leg felt funny. I looked down, and a stingray was nibbling at my leg. You could hear me a half-mile away. I screamed like a bitch and ran for shore. Never go in the Gulf with an open flesh wound.”

“The most common problems we treat are sunburn, ear infections and foot injuries. Actually we see more children with ear infections than sunburn,” says Dr. Eduardo Gonzales, a physician who works at the Destin Clinic, an urgent care center close to the beach. “We also get tourists with jellyfish stings."

Children and teenagers continue to suffer bad sunburn injuries as a spring or summer rite of passage. The deleterious consequences consist of more skin cancers and premature aging decades later. Sun protection, like Gaul, is divided into three parts – sun avoidance, protective clothing and sunscreens. Damaging intense midday UV waves are a good reason to encourage postprandial afternoon naps inside. Hats and wraparound sunglasses have replaced sunbonnets as important components of sun safety.

Sunscreens come as gels, oils, butters, sticks and sprays. Recent market entries include sunscreens incorporated into wipes, moisturizers, shampoos, facial foundations and insect repellants. Teenagers and others with oily skin may prefer gel-based or spray-on products. Some folks are allergic to one or more ingredients in a sunscreen, and contact dermatitis can be a problem. Preparations containing opaque sun blockers such as titanium and zinc oxide can exacerbate facial rosacea and acne problems.

It should go without saying that people with acute sunburn should avoid additional exposure. Most sunburns heal with tincture of time, but cool showers and soaks along with soothing lotions of any brand can help with the discomfort. Low potency over-the-counter steroid creams help along with Tylenol or aspirin for pain. Physicians have an array of more potent steroids and other occasionally needed tricks of the trade.

Swimmer’s ear is the bane of children who take to the water like ducks. The increased moisture from time in the surf coupled with a small ear canal sets the stage for a nice home for bacteria and fungi that thrive in cramped, moist conditions. Treatment depends on the severity of the infection. A simple diluted solution of vinegar often suffices, but most physicians tend toward more potent prescription eardrops.

A good homemade eardrop recipe to prevent swimmers ear calls for mixing one part white vinegar with one part isopropyl rubbing alcohol. Douse all the at-risk ears with several drops of this solution after swimming; it will kill most bacteria and fungi on contact, and the alcohol helps additionally by drying out the ear canal, making its less hospitable for microorganisms. Drug stores sell a similar solution, but every camp I ever went to made their own.
“During dry spells we do get an abundance of jellyfish, and sometimes they are the stinging type,” says Dr. John Kokemor, a New Orleans internist who spends frequent weekends on the Alabama coast. Jellyfish have stinging cells that can stay activated even if the jellyfish is cut apart or dies. The stinging varieties can cause anything from a minor local irritation to shock with cardiovascular collapse depending on the toxicity of the involved species, the dose of the venom and the allergic response of the victim. Fortunately, fatalities are rare, and most persons who seek medical care have only self-limited pain lasting a couple of days. First aid for jellyfish stings includes plain old vinegar, which spells doom to the viable stinging cells.

And just how dangerous are those stingrays? Half a world away, Crocodile Hunter Steve Irwin was pierced in the chest by a stingray and died while snorkeling off the Great Barrier Reef. Maybe the stingrays in Australia are bigger and meaner, or maybe Irwin wasn’t using good sense. Our Gulf coast stingrays may want to nibble, but fortunately they have better manners. Most stingray injuries in our waters are painful punctures of a foot placed by its owner in the wrong place. Stingray punctures can be painful but aren’t deadly unless their spear-like appendage penetrates the chest or abdomen.

Feet are rather tender human appendages once we shed our shoes for the sand and surf. Humans lack protective pads and hooves that serve animals so well. But I have seen some older feet with scales, crusts and calluses thick enough to prevent injuries from at least drink can tabs in the sand. So maybe wear tennis shoes while on the beach and in the surf? No way I’m going to suffocate my toes inside a shoe of any sort once I get near those pristine sandy beaches of the Mississippi, Alabama and north Florida coasts. Our Redneck Riviera has beaches second to none in the world.

Picking the Best Sunscreen

The ideal sunscreen is easy to apply, non-irritating, long lasting and affords complete protection from all wavelengths of dangerous solar energy. Sunscreens fail when the Sun Protector Factor (SPF) isn’t matched to the degree of sun exposure, not enough is applied and reapplications aren’t frequent enough.

New labeling laws prohibit claims of water or sweat resistance, but sunscreens that are relatively water resistant can be so labeled. The American Academy of Dermatology recommends daily sunscreen use for everyone to reduce the risk of skin cancer and slow premature skin aging. In most situations this reeks of overkill to me. Messing with Mother Nature a little bit to prevent sunburn on the beach or when gardening is one thing, but messing with Mother Nature this way on a daily basis may well lead to adverse effects, including Vitamin D deficiency.

According to the AAD, the ideal sunscreen is water-resistant with a SPF of 30 or greater and provides broad-spectrum protection against both UV wavelengths. The AAD advises generously coating all skin not protected by clothing some 20 to 30 minutes before going outside. Most folks don’t use enough. A normal sized person usually needs about as much as will fill a shot glass. Protect lips with a lip balm or lipstick containing sunscreen.

The best type of sunscreen is one you like enough to use repeatedly. There are all sorts of concoctions depending on personal preferences and the area of the body to be protected. The academy suggests creams for dry skin and the face areas, gels for hairy areas as the scalp and male chest, wax sticks for around the eyes, and a spray down for squirming children. Remember the key to successful protection is a liberal application.